UST Program - LG 158 - Sample Letter 3

Name of local agency

Street address

City

SUBJECT: NOTICE OF PROPOSED ACTION SUBMITTED TO LOCAL AGENCY FOR NAME AND ADDRESS OF SUBJECT SITE

In accordance with section 25297,15(a) of Chapter 6.7 of the Health & Safety Code, I, name of primary responsible party, certify that I have notified all responsible landowners of the enclosed proposed action. Check space for applicable proposed action(s):

___ cleanup proposal (corrective action plan)

___ site closure proposal

___ local agency intention to make a determination that no further action is required

___ local agency intention to issue a closure letter

Sincerely,

Signature of primary responsible party

Name of primary responsible party

cc: Names and addresses of all record fee title owners